Douglas Berger psychiatrist in Tokyo is a fully bilingual Japanese/English American board-certified psychiatrist and Director of the Tokyo Meguro Counseling Center. Dr. Berger received his M.D. and psychiatry training from New York Medical College, and his Ph.D. from the Department of Psychosomatic Medicine at the Tokyo University School of Medicine.
Anxiety the chameleon: sleep disturbance, nail biting, intrusive thoughts, can’t make decisions, etc. First nail-down the diagnosis! Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg
Many people are controlling in style. They don’t realize they get aggravated when others stand up for themselves, and they get upset trying to control others. Us: https://t.co/W6SS4mDcjN, https://t.co/urVpIy8MlO
Many persons stable on a medication regimen want to change to something else they hear about or friends tell them. Caution is the word! Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg
Why do some people continue to subject themselves to abuse both physically and psychologically? It’s complex but often results from a “comfort” to have distress to fight against. Us: https://t.co/W6SS4mUflN, https://t.co/urVpIxQD7G
Chronic mild depression that is up and down mixed with actual social stress often results in confusion in the person as to whether they are really ill or if it’s situational. These persons can go for decades without real help. Us: https://t.co/W6SS4mCEuf, https://t.co/urVpIy8ewg
Lately everybody and their grandma have become proud armchair epidemiologists, virologists, maskologists, and vaccinologists. If I disagree with something and remind them, “actually I have a license to practice medicine”, sparks can fly. Very disconcerting.
If a clinical trial endpoint is subjective like depression, there must be a blind placebo control group. If you will blast a building and want to measure the damage, you don't need a placebo control group because this is objective. Clearly, a no-blast will show no damage.
Clinical trials require that the data collection is going to be exact. Many a trial fails when the data is audited. This is called Good Clinical Practice. #clinicaltrials
Poor sleep and meds: many people give-up quickly when there is plenty of chance to adjust dose, type, and regimen where a rotation of drug-type is often effective. #insomnia
Medication doses and formulations can differ from country to country. Creative adjustments of dose breaking pills or emptying capsules and close monitoring until the patient moves into a new stable state are good ways to handle this issue. #drugformulation #medications
Faced with contradictions to a life narrative, people who unreasonably try to fit facts into this narrative inevitably run into the ground or live on in an “unknowing” state of false bliss. Us: https://t.co/xJKjtzqJ7S, https://t.co/bggAMvGq8V
Tantrums since a child, stress over the years, anger outbursts now when life changes Probably nothing new. Us: https://t.co/xJKjtzrgXq, https://t.co/bggAMvGXYt
Inattention is a common cause persons start relationships with problematic people. First you can’t see why they are problematic, then they get upset at your inattention and abuse you. Us: https://t.co/xJKjtzqJ7S, https://t.co/bggAMvGq8V
Young persons adapt to the idea that “things work out in life”. They don't realize there is a race against time to wake up to the fact that people in a reasonable job are those who put in a lot of effort before it’s too late. Us: https://t.co/xJKjtzIjZq, https://t.co/bggAMvY10t
Under stress people can fall into inconsolable distress and fall into unshakable belief in a specific narrative. A mix of sympathy and gentle assuaging that the situation is not as dire as they think can sometimes help. Us: https://t.co/xJKjtzqJ7S, https://t.co/bggAMvGq8V